Claims Processor
16 hours ago
Ampcus Inc. is a leading provider of technology and business consulting services. We are seeking a highly motivated and detail-oriented Claims Processor to join our team.
Job Summary:The Claims Processor will be responsible for reviewing and adjudicating paper and electronic claims. This involves determining the proper handling and adjudication of claims in accordance with organizational policies and procedures.
Key Responsibilities:- Examine and resolve non-adjudicated claims to identify key elements of processing requirements based on contracts, policies, and procedures.
- Process product or system-specific claims to ensure timely payments are generated and calculate deductibles and maximums.
- Research and resolve pending claims using automated system processes.
- Collaborate with the Quality team to ensure clarity on procedures and resolve difficult claims.
- Complete productivity daily data to track performance statistics.
- 1-3 years of experience in claims processing, billing, or medical terminology.
- Demonstrated analytical skills, reading comprehension, and ability to follow directions.
- Basic written and oral communication skills.
- Ability to navigate computer applications.
- High School Diploma or GED.
- Less than one year of experience processing claim documents.
- Ability to work in a fast-paced environment with changing priorities and deadlines.
- Effective communication and customer service skills.
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